Understanding Colorado Medicaid

Medicaid is a Federal and State program that provides healthcare coverage to lower-income individuals and families. Understanding the Medicaid application can be challenging because each state manages its own program differently, making it even more difficult to understand the benefits, services, and application process. Andrea’s Angels Inc. understands that Medicaid is a critical lifeline for millions of Coloradans, that’s why we’re breaking down Colorado Medicaid and its benefits to help you and your loved ones understand the healthcare services you’re entitled to.

Medicaid: AKA “Health First Colorado”

Medicaid in Colorado is known as Health First Colorado. Health First Colorado is public health insurance for Coloradans who meet income and asset eligibility criteria. Medicaid is funded jointly by the federal government and Colorado state government, and is administered by the Department of Health Care Policy & Financing. Every member of Health First Colorado (Medicaid) has a Primary Care Provider and belongs to a regional organization that helps connect people with the health care they need.

A Primary Care Provider (PCP) is the first [point of contact for a patient’s health care. Health First Colorado will assign the insured to a PCP, or the insured party can choose for themselves so long as the chosen provider participates in Health First Colorado. 

Eligibility Requirements: Do I Qualify? 

To be eligible for Colorado Medicaid, you must:

• be a resident of the state of Colorado, a U.S. national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income. 
• One of the following: pregnant, responsible for a child 18 years of age or younger, blind, have a disability or a family member in your household with a disability, or be 65 years of age or older.

What is Covered?

Health First Colorado coverage gives you 3 kinds of basic benefits: 

1. Physical health benefits
2. Dental benefits
3. Behavioral health benefits (mental health and substance use)

For some services, there may be a copay, which is a fixed amount you pay when you get a covered health care service. An insured person will never have to pay more than the co-pay for covered services. For Medicaid, there is no monthly premium nor deductible. Health First Colorado applications are accepted at any time of year for qualified individuals.

Qualification

For income-based Colorado Medicaid, if your family’s income is at or under 138% of the Federal Poverty Guidelines (FPG) ($19,392/year for an individual), you likely qualify. For a household of two, the maximum income level is $26,228/year. For each additional person, add $6,836 to calculate the maximum allowable income for your household size to qualify.

If you do not qualify for Health First Colorado or Child Health Plan Plus, you may still be able to get financial help to lower the cost of private health insurance through Connect for Health Colorado. Connect for Health Colorado is the official health insurance Marketplace for Colorado residents to shop for health plans and access financial help. 

Health First Colorado and Connect for Health Colorado both provide financial help to make health coverage and healthcare more affordable for Coloradans. The amount of financial help you are entitled to is based on the cost of the premiums where you live, how many people are in your household, and your estimated yearly income.

How to Apply

There are 3 ways to apply for Health First Colorado:

• Online: Apply online at healthfirstcolorado.com/appy. This is the fastest way to apply and applicants can check their application status online. 
• In-person: Apply in person at your county of residence’s local county office or at a local application assistance site.
• Phone: To apply by phone call 1-800-221-3943 / State Relay: 711. Phone applications are available Monday through Friday from 8 a.m. to 4 p.m.
• Mail: To apply by mail, download and print a paper application from healthfirstcolorado.com/appy.

For any HealthFirst Colorado application, an applicant will need:

• Social Security numbers for applicants who have them
• Immigration document number for non-citizens
• Employer income information for everyone in your household. Examples include pay stubs or W2 forms
• Contact information (name, address, birthdate) for applicants
• Information and policy numbers for health insurance plans covering members of your household, including Medicare
• Other income information including Social Security Administration (SSA) or Supplemental Security Income (SSI) payments

For more help: 

Andrea’s Angels Inc.’s team of experts are intimately familiar with the Health First Colorado Medicaid application process, and are happy to guide you every step of the way. If you need help finding out if you are eligible for Health First Colorado, call our offices! Any of our staff members will be happy to assist you with the enrollment process.